Parental health and child vulnerability beliefs and child asthma quality of life

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Abstract

Background. Research indicates that inaccurate parental representations of asthma illness and heightened perceptions of child vulnerability to illness and death are factors that contribute to asthma morbidity in children (Halm et al., 2006; Anthony et al., 2003). Literature additionally suggests incompatibility in parent and child reports of somatization (Goldbeck & Bundschuh, 2007) which can cause inaccurate interpretations of asthma symptoms and thus greater asthma morbidity (McQuaid et al., 2007). This paper analyzes models to identify factors that mediate between parental perception variables and their effects on child asthma health related quality of life (HRQoL) and health care behavior. Methods. 115 parent-child black non-Latino, Puerto Rican, and Caucasian dyads were recruited from a Bronx community hospital and completed questionnaires addressing factors mentioned above. Child medication regimen, age, and child and parent race/ethnicity were controlled for in mediation and secondary analyses. Results. Hierarchical regressions and mediation analyses indicated that parental perceived child vulnerability (PCV) did not mediate the relationship between parental general health perceptions (GHP) and child asthma HRQoL . PCV showed only a trend toward significance in mediating the relationship between parental perceived child somatization and child asthma HRQoL, as child age was a strong confounding variable. In an exploratory analysis, parental perceptions of child somatization mediated between parental PCV and child asthma HRQoL, Z= -2.40, p= .022. GHP correlated with parental asthma illness representations, r= .51, p<.001, and these representations were associated with parental PCV scores, r= .27, p=.013. Perceived Child Vulnerability did predict more ER visits for asthma, OR = 2.32, p=.029, 95% CI [1.90, 4.96], but did not predict school absence. Discussion. The present study pointed to the possibility that parental perceptions of child somatization might better explain the relationship between parental PCV and child HRQoL. Parental perceptions of their general health are related to their conceptualizations of asthma illness in their children, and these conceptualizations are in turn associated with their perceptions of child vulnerability. PCV may ultimately influence emergency room utilization. These associations fit into a larger theoretical understanding of the transmission of health beliefs between parents and children and its impact on health behaviors.